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Serum eosinophil cationic protein during treatment of asthma in children
K Juntunen-Backman1, P Järvinen, R Sorva
1Department of Allergic Diseases, Helsinki University Central Hospital, Finland.
Insights
Serum eosinophil cationic protein (ECP) levels decreased in children with asthma after treatment with inhaled budesonide or sodium cromoglycate. Higher baseline ECP correlated with a greater decrease, indicating potential for ECP as an asthma biomarker.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Pharmacology
Background:
- Serum eosinophil cationic protein (ECP) is a proposed marker for bronchial inflammation and hyperreactivity in asthma.
- Asthma management often involves assessing inflammatory markers to guide treatment.
Purpose of the Study:
- To evaluate changes in serum ECP levels in children with asthma following treatment with inhaled budesonide or sodium cromoglycate (SCG).
- To explore the relationship between baseline ECP levels and treatment response.
Main Methods:
- Serum ECP levels were measured before and at 1 and 5 months after initiating treatment.
- Inhaled budesonide (800 mcg/m2 initially, then 400 mcg/m2) or SCG (7 children) was administered daily.
- ECP levels were quantified using radioimmunoassay.
Main Results:
- A statistically significant decrease in serum ECP was observed over 5 months of treatment for both groups combined (p=0.020) and the budesonide group (p=0.049).
- A strong inverse correlation was found between initial ECP levels and the magnitude of ECP decrease during treatment in both budesonide (r=-0.697) and SCG (r=-0.893) groups.
- No significant correlation was found between ECP levels/changes and forced expiratory volume in 1 second percentage (FEV1%) or changes therein.
Conclusions:
- Inhaled budesonide and SCG treatments led to a significant reduction in serum ECP levels in children with asthma.
- The study suggests serum ECP may be a sensitive indicator of treatment response in pediatric asthma.
- Further research is needed to establish the clinical utility of these ECP level changes in asthma management.
Background:
Serum eosinophil cationic protein (ECP) is suggested to reflect the degree of bronchial inflammation and hyperreactivity in patients with asthma. We measured serum ECP levels before and 1 and 5 months after treatment with inhaled budesonide (n = 10) or sodium cromoglycate (SCG) (n = 7) in children with asthma.
Methods:
The daily dose of budesonide was 800 micrograms/m2 during the first month and 400 micrograms/m2 during the next 4 months. ECP levels were determined by radioimmunoassay.
Results:
ECP decreased during the 5 months of treatment (p = 0.020 for treatment groups combined; p = 0.049 for the budesonide group; p = NS for the SCG group). The higher the serum ECP level at entry, the more it decreased during treatment, both in the budesonide group (r = -0.697, p < 0.05) and in the SCG group (r = -0.893, p < 0.05). No correlation was found between the ECP level and the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1%) or between changes in these. However, basal pulmonary function was reduced in 8 of 16 subjects only, and FEV1% did not change significantly in either group. Thus the absence of a correlation is understandable.
Conclusions:
The clinical value of the sensitive decrease in serum ECP remains to be established.